内镜联合早期肠内营养治疗急性重症胆源性胰腺炎31例

Combination of endoscopy and enteric nutrition in treatment of acute severe biliary pancreatitis:an analysis of 31 cases

目的:观察内镜联合早期肠内营养治疗急性重症胆源性胰腺炎的临床效果.方法:对我院2005-2008年收治的急性重症胆源性胰腺炎患者31例行内镜ERCP+EST+ERBD,同时放置肠内营养管行早期肠内营养,并与36例常规治疗联合肠内外营养的患者进行比较.分别对患者术后主观症状、临床检查、化验检查、TNF-α、血清内毒素含量、CT结果、患者总住院费用及住院时间的指标进行比较.结果:入选患者可顺利完成内镜治疗,对早期肠内营养能较好的耐受.内镜联合早期肠内营养方案对患者主观症状的改善、临床指征的改善、实验室检查、TNF-α、内毒素血症、CT结果、患者住院费用、住院时间方面整体优于传统治疗联合肠内外营养组.结论:内镜联合早期肠内营养治疗急性重症胆源性胰腺炎是安全、有效、经济的治疗方案.

AIM： To evaluate the therapeutic efficacy of endoscopy and enteric nutrition （EN） in acute severe biliary pancreatitis at early stage. METHODS： The clinical data of patients, who were admitted in our department from January 2005 to July 2008, were collected and the diagnoses were acute severe biliary pancreatitis （ASBP）. Those patients were randomly divided into two groups （E-group and R-group）： E-group＇s treatment protocols were ERCP ＋ EST ＋ ERBD and Enteral Nutritional on early stage; R-group＇ s treatment protocol was orthodox treatment and Total Parenteral Nutrition （TPN） ＋ EN. We compared the dates of two groups in subjective symptoms, signs, chemical examinations, endotoxin of plasma, TNF-α, computed tomography grades, cost of hospitalization, length of hospitalstay. All of dates showed that E group had an advantage in comparison with R group. RESULTS： All patients involved completed our therapy, and received the EN at early stage. Endoscopy and enteric nutrition significantly improved subjective symptoms, clinical signs, laboratory examinations, TNF-α, endotoxin, significantly reduced hospital fees, length of hospital stay. CONCLUSION： Endoscopy and enteric nutrition at early stage is of effectiveness, safy and economic protocol in acute severe biliary pancreatitis.